Information Collection Request

License for the Use of Personally Identifiable Information Protected Under the E-Government Act of 2002, Title V and the Privacy Act of 1974

ICR 201805-2528-002 · OMB 2528-0297 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
omb83-c-PDR-MTO-Removal.pdf Justification for No Material/Nonsubstantive Change Uploaded 2018-05-23 Available
60 day Correction Notice for Personally Identifiable Information.pdf Supplementary Document Uploaded 2016-09-30 Available
Data_File_Destruction_Form (2016).docx Supplementary Document Uploaded 2016-09-30 Available
SS -License for the Use of Personally Identifiable Info - 9-30-16 (Final).docx Supporting Statement A Uploaded 2016-09-30 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
223754 Recordkeeping Other-Application Unchanged
223752 Final Reports Other-Application Unchanged
223751 Annual Reports Other-Application Unchanged
206961 Application for Data License Other-Affidavit of Nondisclosure Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2020 01/31/2020 01/31/2020
94 0 94
70 0 70
3,380 0 3,380





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Application for Data License N/A Data License Application 2018
Final Reports
Annual Reports
Recordkeeping

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 94 94 0 0 0 0
Annual Time Burden (Hours) 70 70 0 0 0 0
Annual Cost Burden (Dollars) 3,380 3,380 0 0 0 0


Reginfo record details
  No